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General NPI Number Information
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NPI Number | 1598018376
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Entity Type | Individual
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Provider Name | EVAN ANDREW WHITE PHARMD
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Gender | Male
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Dates
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Enumeration Date | 10/18/2012
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Last Update Date | 10/18/2012
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Provider Practice Location Address
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Address Line | 1809 E ALLEGHENY AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19134-3119
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Country | US
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Telephone | 215-426-0956
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Fax |
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Provider Business Mailing Address
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Address Line | 1440 MOUNT VERNON ST APT 102
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City | PHILADELPHIA
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State | PA
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Zip | 19130-2946
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Country | US
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Telephone | 757-572-2092
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 0202209965
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RP446656
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 28RI03481600
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License Number State | NJ
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